Drugs List

Therapeutic Indications

Uses

Skin conditions responsive to topical corticosteroids

For the treatment of inflammatory and pruritic manifestations of corticosteroid responsive dermatoses.

Contraindications

Skin infection

Precautions and Warnings

Breastfeeding
Pregnancy

Contains cetostearyl alcohol: may cause irritation
Contains propylene glycol: may cause irritation
Occlusive dressings can increase the likelihood of systemic absorption
Adrenal suppression may occur even without occlusion
Prolonged/excessive use may lead to adrenal suppression
Discontinue if irritation or sensitisation occur
Avoid long term continuous therapy
Advise patient residue on clothing/bedding may cause fire hazard
Fire hazard: Keep away from naked flames and potential sources of ignition

Systemic absorption of topical corticosteroids may be increased if extensive body surface areas are treated or if the occlusive technique is used. Suitable precautions should be taken under these conditions or when long-term use is anticipated, particularly in infants and children.

Paediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced hypothalamic-pituitary-adrenal (HPA) axis suppression and to exogenous corticosteroid effects than mature patients due to a greater absorption due to a large skin surface area to body weight ratio.

HPA suppression, Cushing's syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include low plasma cortisol levels, and an absence of response to ACTH stimulation. Manifestations of intracranial hypertension include a bulging fontanelle, headaches and bilateral papilloedema.

Pregnancy and Lactation

Pregnancy

Use alclometasone dipropionate with caution during pregnancy.

The manufacturer advises caution if alclometasone dipropionate is used during pregnancy. At the time of writing, safety of topical corticosteroid use during pregnancy has not been established and should only be used if the potential benefit justifies the potential risk to the foetus. It is recommended to avoid using large amounts and for long periods of time if possible.

Lactation

Use alclometasone dipropionate with caution during breastfeeding.

The manufacturer advises caution if alclometasone dipropionate is used during breastfeeding. At the time of writing it is unknown whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Effects on exposed infants are unknown.

Side Effects

Acne-like eruptions
Allergic contact dermatitis
Cushing's syndrome
Erythema at application site
Folliculitis
Growth retardation (children)
Hypertrichosis
Hypopigmentation
Intracranial hypertension
Irritation (localised)
Itching at application site
Local burning
Maceration of skin
Miliaria
Perioral dermatitis
Rash
Secondary infections
Sensitisation
Skin atrophy
Striae
Superficial vascular dilation
Suppression of the hypothalamic-pituitary-adrenal axis

Presentation

Topical preparations of alclometasone dipropionate

Drugs List

Therapeutic Indications

Uses

Skin conditions responsive to topical corticosteroids

For the treatment of inflammatory and pruritic manifestations of corticosteroid responsive dermatoses.

Dosage

Adults

Children

Contraindications

Skin infection

Precautions and Warnings

Breastfeeding
Pregnancy

Contains cetostearyl alcohol: may cause irritation
Contains propylene glycol: may cause irritation
Occlusive dressings can increase the likelihood of systemic absorption
Adrenal suppression may occur even without occlusion
Prolonged/excessive use may lead to adrenal suppression
Discontinue if irritation or sensitisation occur
Avoid long term continuous therapy
Advise patient residue on clothing/bedding may cause fire hazard
Fire hazard: Keep away from naked flames and potential sources of ignition

Systemic absorption of topical corticosteroids may be increased if extensive body surface areas are treated or if the occlusive technique is used. Suitable precautions should be taken under these conditions or when long-term use is anticipated, particularly in infants and children.

Paediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced hypothalamic-pituitary-adrenal (HPA) axis suppression and to exogenous corticosteroid effects than mature patients due to a greater absorption due to a large skin surface area to body weight ratio.

HPA suppression, Cushing's syndrome, linear growth retardation, delayed weight gain, and intracranial hypertension have been reported in children receiving topical corticosteroids. Manifestations of adrenal suppression in children include low plasma cortisol levels, and an absence of response to ACTH stimulation. Manifestations of intracranial hypertension include a bulging fontanelle, headaches and bilateral papilloedema.

Pregnancy and Lactation

Pregnancy

Use alclometasone dipropionate with caution during pregnancy.

The manufacturer advises caution if alclometasone dipropionate is used during pregnancy. At the time of writing, safety of topical corticosteroid use during pregnancy has not been established and should only be used if the potential benefit justifies the potential risk to the foetus. It is recommended to avoid using large amounts and for long periods of time if possible.

Lactation

Use alclometasone dipropionate with caution during breastfeeding.

The manufacturer advises caution if alclometasone dipropionate is used during breastfeeding. At the time of writing it is unknown whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Effects on exposed infants are unknown.

Side Effects

Acne-like eruptions
Allergic contact dermatitis
Cushing's syndrome
Erythema at application site
Folliculitis
Growth retardation (children)
Hypertrichosis
Hypopigmentation
Intracranial hypertension
Irritation (localised)
Itching at application site
Local burning
Maceration of skin
Miliaria
Perioral dermatitis
Rash
Secondary infections
Sensitisation
Skin atrophy
Striae
Superficial vascular dilation
Suppression of the hypothalamic-pituitary-adrenal axis

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: October 2020

Reference Sources

Summary of Product Characteristics: Alclometasone Dipropionate 0.05% w/w cream. Aspire Pharma Ltd. Revised December 2019.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 13 October 2020